Prior to surgery: Navy neurologist Mill Etienne measures the skull of an 11-month-old baby whose head is swollen due to blocked spinal fluid ducts. The boy's mother sits on the opposite bunk.

By Steve Sternberg, USA TODAY

Doctors aboard the floating hospital ship USNS Comfort have performed a lifesaving operation on an 11-month-old Haitian boy with severe hydrocephalus to relieve pressure inside the baby's skull, Navy Cmdr. Dennis Rivet, a neurosurgeon, said Tuesday.

Hydrocephalus occurs when spinal fluid builds up inside the brain, compressing it against the skull. The boy's skull had swollen so much that the neurologist who first examined him, Lt. Cmdr. Mill Etienne, needed two tape measures to check its circumference.

Rivet says he performed the surgery on Friday and put in a shunt to drain the trapped fluid. Without surgery, the pressure eventually would have caused such severe brain damage that the boy, Natanael Mythil, would have died.

The case provoked an ethical debate aboard the Comfort, which is anchored off Port-au-Prince to care for earthquake victims. Some doctors worried that the surgery would merely prolong the family's agony, because many shunts eventually fail and few, if any, Haitian doctors are equipped to repeat the procedure.

The boy's mother, Cheretal Kettelil, 35, told Etienne that long before the Jan. 12 quake, Haitian doctors had performed a superficial exam and sent the boy on his way. "They did nothing, no CT scan, nothing," Etienne says the mother told him.

Rivet argued that the procedure has been done successfully in poor African nations and that it would offer the boy decades of normal life. The ship's ethics committee considered the case and decided to go ahead with the operation, he says. "They felt, as I did, that the case was appropriate for surgery," Rivet said in an e-mail from the Comfort.

A CT scan after the surgery showed that the fluid-filled cavities in the boy's brain have started shrinking, as has the circumference of his skull, Etienne says.

Rivet says Natanael will need therapy to sit up, eat with his hands and do other things children his age can do. "We have already started this process, and his mother is understandably extremely happy," he says.

Doctors on the ship are searching for a Haitian neurosurgeon who can keep tabs on the boy as he grows. They hope to identify one before he's sent home. "Despite the many challenges the patient and his mother will undoubtedly face in Haiti, I remain optimistic about his long-term prognosis," Rivet says.

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